This blog post is part of a spotlight series featuring examples of programs and community design changes that get older adults moving. The posts were first published as part of the Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adults and highlight ways to apply strategies from the report in different settings.
At a glance
Who? University of California San Francisco cardiac rehabilitation program
What? A medically supervised program for people with heart disease that combines physical activity, health behavior counseling, and psychological support.
Where can I learn more? https://cardiacrehab.ucsf.edu/about-program
For people with heart disease, like those who’ve had a heart attack or heart surgery, the process of improving their health can feel daunting. Many may wonder what activities are safe for them and how they can prevent future heart problems. That’s why organizations like the University of California San Francisco (UCSF) offer cardiac rehabilitation programs.
Cardiac rehab is designed to help heart disease patients regain their strength and mobility and to teach them how to protect their heart health moving forward. While physical activity is a main component of cardiac rehab, it’s not the sole focus. Instead, physical activity is combined with education about eating healthy, lowering stress, and managing other risk factors for heart disease. Cardiac rehab programs also focus on motivational counseling and psychological support to help patients set goals — and to increase their confidence as they get back to everyday activities like work and hobbies.
At UCSF, the cardiac rehab team aims to create an individualized plan for each patient, based on their needs, abilities, and preferences. “It’s not a one-size-fits-all exercise program, even though we try to work everybody up to 150 minutes of physical activity a week,” says Dr. Alexis Beatty, a cardiologist and associate professor at UCSF. “There’s a lot of different ways to get there. We always try to meet patients where they are — even if that means starting with 5 minutes of physical activity a day and working up to more.”
Strategy: Adapt to Meet Patients’ Needs
Most cardiac rehab programs take place at health care facilities — like hospitals and rehab centers — which means patients have to travel to participate. As a result, people in rural areas and those facing barriers like a lack of transportation may not have access to cardiac rehab.
But research shows that virtual, home-based exercise programs can be just as effective as in-person ones. So the UCSF team developed a home-based cardiac rehab option that includes virtual meetings with an exercise physiologist, group exercise sessions, and health behavior counseling. The team adapted exercises so that patients could do them without special equipment like treadmills and gave patients resources to help them get active at home, including links to online exercise videos.
“You have to find what works for patients,” Beatty says. “A lot of our older adult patients enjoy exercising to workout videos on YouTube — old Jane Fonda videos are a favorite!”
This virtual approach has proven to be effective in helping patients meet their cardiac rehab goals. Patients work closely with doctors and exercise physiologists to make sure home-based activities are safe for them and to learn how to do them correctly on their own.
Impact: Lower Barriers for Older Adults
Research shows that cardiac rehab programs lower patients’ risk of having another heart attack and help them feel better overall. Yet many patients with heart disease who could benefit from a cardiac rehab program don’t enroll in one — which may be due to barriers like a lack of program availability and long travel distances. The UCSF cardiac rehab program’s flexible hybrid approach helps address these barriers. Over 200 patients participate in the program each year, and about half are older adults.
The UCSF team also provides education about using virtual options, which may be especially helpful for older adults. “Some of our older adult patients aren’t comfortable using technology,” Beatty says. “But many benefit from in-person education and training on how to use virtual options — and it ends up working quite well for them after a while.”
Key Takeaway: Empowering Patients Helps Lead to Lasting Success
Beatty says the UCSF cardiac rehab program’s success is due in part to its focus on meeting patients where they are and empowering them to set their own goals.
“We try to inspire patients to own their own change,” Beatty says, “and to support them as they build healthy routines they can maintain in the long term.
